Preparing for Therapy

Often I hear in my sessions I wish I had know certain things about therapy before I started. If I had, I probably wouldn't have put off going for so long, not to mention I might've gotten more out of therapy sooner. So, I'm passing on a few findings that have helped current and former patients. Just keep in mind that therapy is highly personal and not everything here will apply to every person.

Some of the time, you're not going to like therapy — at least, not in the way you usually like things.

In general, "liking therapy" doesn't mean always enjoying yourself and having a pleasant time. It's kind of like going to the gym in that more often than not, "having gone" feels a lot better than the actual "going." And you have to put in the work to feel better longterm.

If you decide to make an appointment that time is 100% dedicated to you. For your therapist to listen unconditionally and not judge.

Therapy is a place to focus on you and you only, without feeling guilty or selfish. You don't have to ask your therapist how they're doing. You don't have to make sure you're not talking too much. You don't have to balance your emotional needs with being supportive and reciprocal. You don't have to pretend to be strong for anyone's sake. You just get to focus on yourself, which sometimes can be life-changing.

You shouldn't be discouraged if you don't have some big cinematic breakthrough — it's more about making lots of tiny changes.

TV and movies have misled a lot of people about what therapy is supposed to look like. Don't think of therapy as working toward that breakthrough. Instead, think of it as improving, healing, and fortifying yourself one session at a time.

You can mistake not liking your therapist with not liking the things they're saying. This is a normal feeling.

Sometimes, therapists will tell you things you don't want to hear and challenge you to reflect on less-than-flattering things about yourself. It's not fun. And if you're going to therapy for the first time, that's enough to convince you that they're not the right therapist for you and never return. After that, I switched over to a therapist whose quiet, nurturing style made me feel warm and glowy — and after seeing her for four months, I realized I hadn't learned anything new about myself or picked up any useful skills, because she wasn't challenging me.

What kind of therapy style works for you will be an incredibly personal decision, but as you navigate the choice, just remember that the criteria for a good therapist is a lot different than other relationships in your life. You're not looking for someone you want to get brunch with. Even the best therapist will annoy you sometimes.

Going to therapy doesn't necessarily mean having to face that one difficult thing you're not ready to talk about, so don't let that put you off.

If you're avoiding therapy because you're scared to confront certain stuff, go anyway. A good therapist won't push you to talk about skeletons in your closet or deep-rooted childhood issues if you don't want to, but they *will* help you move in a direction where you'll be ready to deal with it eventually. And in the meantime, you can tackle smaller things.

You're allowed to push back against your therapist — and whine and rant and argue. You can even tell me I don't understand, I don't get it, I'm wrong.

A therapist can sometimes feels like an intimidating authority figure in so many ways — you may feel they're the expert on the things you're seeking help for, they're put together while you're vulnerable and messy, they remain calm and collected as they facilitate your falling apart. When sitting across from someone like that, it can be easy to default to addressing them with deference and swallowing everything they say like a bitter pill.

But I've learned therapy is so much better when you're an active participant — and sometimes that involves things getting heated and having disagreements. I'm not saying you should ever be disrespectful or mean to your therapist. Remember we are on the same team. But at the same time, as your therapist I will push you to not hold anything back and even though it's hard, therapy can become a place where you can express the good, the bad, and the ugly without fear of judgment, and that's cathartic.

Therapy is a a low-stakes place to practice all the more unsavory forms of communication, like standing up for yourself, arguing, apologizing, or being vulnerable.

Things you can practice with your therapist: asking for a raise, breaking up with a friend, talking about how I feel even though it's embarrassing, dealing with a friend's mental health crisis, admitting my faults out loud, never feeling good enough, fear of commitment, relationship issues, sexual issues, along with many other topics.

And even if you're not role-playing specific scenarios, you can learn a lot of communication-related lessons — like how you come across to other people or how to pick up on social cues.

A session can feel frustratingly short, so it helps to think about what you want to talk about beforehand. Just don't expect to leave having covered everything.

Therapy sessions typically run 45–60 minutes and you'll soon find out that it rarely feels long enough. Eventually, you kind develop a sense for what 45–60 minutes feel like and can prioritize accordingly.

Still, it can be frustrating — especially when you hit your stride near the end of the session. Remind yourself you can keep coming to therapy for as long as you want, and you can get to everything *eventually*. Therapists take notes for a reason and they'll keep track of threads that got lost due to time constraints.

Not every session has to be super deep or emotional. Some days, you're just going to want to talk about a fight you're having with a friend or a minor work frustration and that's okay.

Bonus of ranting in therapy: It lightens the load you put on the friends you usually vent to, so you don't accidentally turn them into an emotional laundry line.

But you have to be careful that you’re not just spending sessions ranting (unless that’s why you sought out therapy).

At any given time, there is a surface-level grievance I can bloat up into a session-long rant, and I often exercise that skill despite the long list of deep-rooted issues I should be working on instead. Because that's the thing — ranting is so much easier than grappling with your demons. It's more satisfying than sitting with your insecurities. It's less terrifying than stripping down emotionally and doing the hard work.

But you have to push yourself or give your therapist permission to push you, because it's you, not them, who's in charge of how you spend your session for the most part. One thing that helps with this is making a list of goals for therapy and checking in with your therapist about your progress. What do you really want to get out of being there? And are you spending your sessions slowly but intentionally working toward those goals?

Your therapist is a great person to ask, "Is it me or them?" re: many of life's complicated conflicts.

Sometimes things are your fault. It happens to the best of us. Luckily, a therapist is an invaluable objective resource to help figure out if you're in the wrong or if there's a pattern of behavior that inevitably causes stressful, bad things to happen.

For example, if your friendships keep ending, is it because you haven't been a very good friend or is it because you gravitate toward incompatible or unhealthy friendships in the first place? Or if you've been fired from your last couple of jobs, are you having an insane streak of bad luck or is there something amiss that you're not aware of? Your therapist can help you illuminate it.

Taking the time to jot down thoughts and reflect after each session is an extremely good way to get the most out of therapy.

I encourage anyone in therapy to have a notebook or tablet for to retain and put into practice stuff you're learning, taking notes during or after each session is a helpful tool.• A summary of what you covered

• Key lessons or things you want to remember

• What things were hard to talk about and why

• Things you either forgot to bring up or that you want to revisit next session

I've learned that therapy looks very different for different people. Sometimes all you need to do is find a therapist you feel comfortable with, trust the process, and go from there.